Biomedical engineers at New Jersey Institute of Technology (NJIT) will use new technology to help children with cerebral palsy improve their movements, reduce stiffness in their joints and live fuller and more independent lives.
Small robots mounted on wheelchairs, interactive video games and a robotic arm that can be programmed to guide and aid human motion – these are just a few of the technologies the engineers will use to help these children improve their muscular control and movements.
“Those of us without disabilities can’t really understand how much extra effort goes into doing the things of everyday life,” said Richard Foulds, PhD, an associate professor in the biomedical engineering department at NJIT. “In a nation of technological riches, there is no better way for engineers to use their creative talents than to find new methods and devices that help children with cerebral palsy overcome their daily barriers.”
Foulds is director of the newly formed Rehabilitation Engineering Research Center (RERC) at NJIT, funded by a $4.75 million grant from the National Institute on Disability and Rehabilitation Research, in Washington, D.C. The institute supports research for the rehabilitation of people with disabilities. The grant, awarded on Nov. 1, 2005, will run for five years.
The strength of the center, said Foulds, is the synergy it will create between NJIT and its collaborating institutions: Children’s Specialized Hospital, Mountainside, the largest pediatric rehabilitation hospital in the country, which will be the clinical site for the research; Rutgers-New Brunswick, and the University of Medicine and Dentistry of New Jersey, (UMDNJ) Newark. Sergei Adamovich, PhD, assistant professor in the biomedical engineering at NJIT, and Bruno Mantilla, MD, a special lecturer in the same department, will serve as co-project directors for the center.
Children with cerebral palsy have limited use of their arms due to the discoordination of their neural motor control and stiffness of their joints. The stiffness results from spasticity, the involuntary muscle tightness that occurs in about two-thirds of children with cerebral palsy. These difficulties interfere with the way these children walk, play and perform the manual tasks needed for studying - writing, typing or holding a book.
NJIT researchers have been working with a robotic arm, called the Haptic Master, to help stroke patients overcome spasticity and re-learn the movements they need to live independently; and this robot will be adapted so the children can use it. A child with cerebral palsy will hold onto the robot’s arm, which is programmed to perform intense, repetitive arm and finger motions. The children will do the exercises while watching virtual reality games on a computer - games that both guide their motions and make the therapy fun. They will also wear a computerized cable glove that helps them move their paralyzed fingers. The repetitive motions and exercises will eventually retrain their brains so that the children will have better manual coordination, Foulds said. The HapticMaster could eventually become a common form of physical therapy for children with cerebral palsy, he added.
Researchers at the center will create new interactive video games that can be played by children with cerebral palsy. The games will not use joysticks, which use only the hand, but will have components that involve entire body movements. These games will be customized for each child based on his or her therapist’s input, and will encourage children to have fun while they improve their motion skills.
Another approach the center will use to reduce spasticity is to stimulate the balance system in the inner ear and generate neural signals that briefly cause the brain to send signals that relax the muscles. During the short period of time in which spasticity is also lowered, researchers will seek to understand how spasticity interferes with the children’s movement. “It may even be possible to make therapy more effective so that their muscular coordination may be improved for the long-term,” said Foulds.
Many children who use electric wheelchairs also have limited use of their arms and hands, Foulds said. Most are unable to move their arms through a full range of motion, and are thus unable to turn a door knob, get a glass of water or take a book from a shelf. The center will use two new robots that can be mounted on wheelchairs and programmed to help the children better control their movements and accomplish everyday tasks.
Children who sit all day in wheelchairs, moreover, do not receive the same mechanical forces on the long bones of their legs as children who walk. These children are thus more prone to developing osteoporosis. The center will study the bone loss in wheelchair users and develop a technology that applies mechanical forces on their long bones to help prevent osteoporosis.
In addition to research and development, the center will host a number of educational initiatives for NJIT students, children with disabilities and their families, added Foulds. These initiatives include online-information services, new graduate courses, and research projects conducted by students. Disabled students, both at the high school level and at the undergraduate level, will be invited to participate in the research projects.
Before coming to NJIT in 2000, Foulds developed and directed for 12 years the Applied Science and Engineering Laboratories at A.I. DuPont Children’s Hospital in Wilmington, Del. Foulds built this laboratory into an internationally known center for pediatric rehabilitation. During his tenure there, Foulds initiated and directed three rehabilitation centers. Foulds, a former president of the Rehabilitation Engineering Society of North America, is a leader in the rehabilitation engineering community.
“New Jersey has a richness of rehabilitation resources that have been channeled into this new center,” said Foulds. “We are poised to advance the understanding of pediatric disabilities and to improve the quality of new therapeutic techniques. The next five years will be both exciting and productive. Technology, backed with supporting research, offers the potential to change lives.”